A follow-up study of patients with bulimia

Abstract

A series of 75 patients with bulimia were contacted for follow‐up 12 to 15 months following outpatient evaluation in an eating disorders clinic. Overall, most patients were improved as to their eating behavior at follow‐up, although the majority continued to report bulimic behavior. Most patients had participated in at least one type of therapy subsequent to evaluation and more than 20 % had received antidepressant treatment.

Outcome in bulimia nervosa

“…Slightly more studies found greater duration to be a significant predictor of negative outcome (17,51,55,59) than found it to be insignificant (3,4,9). However, duration at presentation may select a subset of women with a more chronic form of the disorder (e.g., the nearly 20% who continue to meet full criteria more than 5 years after presentation).…”

“…Fewer studies found age to be a significant predictor (3,13) than those that found it not predictive (4,9,47,51,53,59,60). In the two studies that found that age at study entry predicted outcome, one (13) found that older age predicted positive outcome, and the other (3) found that younger age predicted positive outcome.…”

Outcome in bulimia nervosa

“…Slightly more studies found greater duration to be a significant predictor of negative outcome (17,51,55,59) than found it to be insignificant (3,4,9). However, duration at presentation may select a subset of women with a more chronic form of the disorder (e.g., the nearly 20% who continue to meet full criteria more than 5 years after presentation).…”

“…Fewer studies found age to be a significant predictor (3,13) than those that found it not predictive (4,9,47,51,53,59,60). In the two studies that found that age at study entry predicted outcome, one (13) found that older age predicted positive outcome, and the other (3) found that younger age predicted positive outcome.…”

Outcome and prognostic variables in bulimia nervosa

“…The greatest reduction in symptoms has been reported in trials of intensive psychotherapy (Lacey, 1983;Freeman et al, 1988;Fairburn et al, 1991), and these studies have also reported a remarkably good outcome at 1 year. However, the majority of published ccc 0276-347a/93/020135-i 1 treatment studies, using different psychotherapies and pharmacotherapies, have reported that a substantial proportion of patients are treatment resistant (Russell, Checkley, Feldman, & Eisler, 1988;Fichter et al, 1991;Freeman, Davies, & Morris, 1990;Fluoxetine Bulimia Nervosa Collaborative Study Group, 1992), and many others remain prone to relapse at up to 5 years (Agras et al, 1992;Fichter, Quadflieg, & Ref, 1992;Swift, Ritholz, Kalin, & Kaslow, 1987;Hsu & Holder, 1986;Mitchell, Davis, Goff, & Pyle, 1986;Michell et al, 1989). Although the published evidence suggests that cognitive-behavioral therapy is one of the most effective treatments in the short and medium term, this labor-intensive treatment is not always available, and may be an inefficient method of treating those patients who would respond well to brief psychotherapy or medication.…”

Two year follow-up of bulimia nervosa: The importance of abstinence as the criterion of outcome

“…The findings of this study also indicated that the long-term posttreatment course for patients with BN is unstable, fluctuating between states of remission and relapse, and thus support other investigations that have found similar signs of chronicity (Keller et al, 1989;Swift et al, 1987;Mitchell et al, 1986). Some subjects who were asympto- 10.0 matic at the end of treatment were fully relapsed at the time of the 2 year assessment while others who had demonstrated a "poor" treatment response, that is, were considered as treatment failures, were found to be asymptomatic.…”

Outcome in bulimia nervosa

“…Slightly more studies found greater duration to be a significant predictor of negative outcome (17,51,55,59) than found it to be insignificant (3,4,9). However, duration at presentation may select a subset of women with a more chronic form of the disorder (e.g., the nearly 20% who continue to meet full criteria more than 5 years after presentation).…”

“…Fewer studies found age to be a significant predictor (3,13) than those that found it not predictive (4,9,47,51,53,59,60). In the two studies that found that age at study entry predicted outcome, one (13) found that older age predicted positive outcome, and the other (3) found that younger age predicted positive outcome.…”

Outcome and prognostic variables in bulimia nervosa

“…The greatest reduction in symptoms has been reported in trials of intensive psychotherapy (Lacey, 1983;Freeman et al, 1988;Fairburn et al, 1991), and these studies have also reported a remarkably good outcome at 1 year. However, the majority of published ccc 0276-347a/93/020135-i 1 treatment studies, using different psychotherapies and pharmacotherapies, have reported that a substantial proportion of patients are treatment resistant (Russell, Checkley, Feldman, & Eisler, 1988;Fichter et al, 1991;Freeman, Davies, & Morris, 1990;Fluoxetine Bulimia Nervosa Collaborative Study Group, 1992), and many others remain prone to relapse at up to 5 years (Agras et al, 1992;Fichter, Quadflieg, & Ref, 1992;Swift, Ritholz, Kalin, & Kaslow, 1987;Hsu & Holder, 1986;Mitchell, Davis, Goff, & Pyle, 1986;Michell et al, 1989). Although the published evidence suggests that cognitive-behavioral therapy is one of the most effective treatments in the short and medium term, this labor-intensive treatment is not always available, and may be an inefficient method of treating those patients who would respond well to brief psychotherapy or medication.…”

Two year follow-up of bulimia nervosa: The importance of abstinence as the criterion of outcome

“…The findings of this study also indicated that the long-term posttreatment course for patients with BN is unstable, fluctuating between states of remission and relapse, and thus support other investigations that have found similar signs of chronicity (Keller et al, 1989;Swift et al, 1987;Mitchell et al, 1986). Some subjects who were asympto- 10.0 matic at the end of treatment were fully relapsed at the time of the 2 year assessment while others who had demonstrated a "poor" treatment response, that is, were considered as treatment failures, were found to be asymptomatic.…”

Outcome in bulimia nervosa

“…Slightly more studies found greater duration to be a significant predictor of negative outcome (17,51,55,59) than found it to be insignificant (3,4,9). However, duration at presentation may select a subset of women with a more chronic form of the disorder (e.g., the nearly 20% who continue to meet full criteria more than 5 years after presentation).…”

“…Fewer studies found age to be a significant predictor (3,13) than those that found it not predictive (4,9,47,51,53,59,60). In the two studies that found that age at study entry predicted outcome, one (13) found that older age predicted positive outcome, and the other (3) found that younger age predicted positive outcome.…”

Outcome and prognostic variables in bulimia nervosa

“…The greatest reduction in symptoms has been reported in trials of intensive psychotherapy (Lacey, 1983;Freeman et al, 1988;Fairburn et al, 1991), and these studies have also reported a remarkably good outcome at 1 year. However, the majority of published ccc 0276-347a/93/020135-i 1 treatment studies, using different psychotherapies and pharmacotherapies, have reported that a substantial proportion of patients are treatment resistant (Russell, Checkley, Feldman, & Eisler, 1988;Fichter et al, 1991;Freeman, Davies, & Morris, 1990;Fluoxetine Bulimia Nervosa Collaborative Study Group, 1992), and many others remain prone to relapse at up to 5 years (Agras et al, 1992;Fichter, Quadflieg, & Ref, 1992;Swift, Ritholz, Kalin, & Kaslow, 1987;Hsu & Holder, 1986;Mitchell, Davis, Goff, & Pyle, 1986;Michell et al, 1989). Although the published evidence suggests that cognitive-behavioral therapy is one of the most effective treatments in the short and medium term, this labor-intensive treatment is not always available, and may be an inefficient method of treating those patients who would respond well to brief psychotherapy or medication.…”

Two year follow-up of bulimia nervosa: The importance of abstinence as the criterion of outcome

“…The findings of this study also indicated that the long-term posttreatment course for patients with BN is unstable, fluctuating between states of remission and relapse, and thus support other investigations that have found similar signs of chronicity (Keller et al, 1989;Swift et al, 1987;Mitchell et al, 1986). Some subjects who were asympto- 10.0 matic at the end of treatment were fully relapsed at the time of the 2 year assessment while others who had demonstrated a "poor" treatment response, that is, were considered as treatment failures, were found to be asymptomatic.…”